AGACNP certification cheat sheet
Pulmonary embolism: quick reference
Testing pathway, severity classes and anticoagulant choices.
Reviewed by a licensed nurse · 2 November 2026
Testing pathway
| Probability | Next test |
|---|---|
| Low | D-dimer. If negative, stop. If positive, imaging. |
| Intermediate | D-dimer or imaging, by local protocol |
| High | Imaging directly. Do not rely on D-dimer. |
| Unstable | Bedside echocardiogram, treat on clinical suspicion |
Anticoagulant notes
| Agent | Note |
|---|---|
| Low-molecular-weight heparin | Preferred in pregnancy and in cancer-associated disease |
| Unfractionated heparin | Preferred when reperfusion or renal failure is likely, since it is quickly reversible |
| Direct oral anticoagulants | Oral first-line for most stable patients |
| Warfarin | Needs an overlap with a parenteral drug and an INR of 2 to 3 |
Educational content for exam preparation. It is not clinical guidance and does not replace your facility's policies, current professional guidelines or the advice of a qualified clinician.
boardreadynurse.com · ESC Guidelines for acute pulmonary embolism